Abstract
The preterm premature rupture of membranes occurring in early pregnancy at less than 23 - 24 weeks (prior to fetal viability), has higher risk for early preterm delivery, and therefore, the poorer the prognosis with poor chance of neonatal survival and a high rate of severe, long-term neonatal morbidity among survivors. In such cases in absence of overt evidence of intrauterine infection at the time of diagnosis termination of pregnancy or expectant management is generally offered modality of treatment, the prior being commonly preffered. When expectant management is instituted, it is very rare that spontaneous resealing of the membranes occurs with the outcome that is equivocal to normal pregnancy. The presented case is an example of this rare happening. A 25-year-old, mangolian, primigravida at 20 weeks of pregnancy had spontaneous preterm premature rupture of membranes. After 8 days of expectant management, she had cessation of amniotic fluid leak and could continue pregnancy till term with normal feto-maternal outcome at 37 weeks of pregnancy. The risk of infection increases with prolongation of latency period but in this case, the latency period was prolonged for more than 16 weeks and there was no evidence of infection, with normal feto-maternal outcome at term. This is the first case of its kind happened in our hospital and deserves to be reported. It is expected that this article will reveal the possibility of resealing of spontaneous preterm premature rupture of membrane with proper expectant management.
Highlights
Preterm premature rupture of membranes (PPROM) is a common clinical condition with significant impacts on obstetric outcome and is considered one of the “great obstetrical syndromes” responsible for spontaneous preterm birth [1]
This study indicates that the risks of complications are expected to be still higher in case of PPROM in less than 22 weeks of gestation [12]
In most patients with preterm PROM following amniocentesis, the membranes reseal with restoration of normal amniotic fluid volume. This situation is different from spontaneous preterm PROM in which apparent resealing of the membranes and reaccumulation of normal amniotic fluid volume is far less common, especially if it has not occurred within 72 hours of presentation
Summary
Preterm premature rupture of membranes (PPROM) is a common clinical condition with significant impacts on obstetric outcome and is considered one of the “great obstetrical syndromes” responsible for spontaneous preterm birth [1]. The product of conception in the amniotic cavity is kept safe and sealed by this membrane. It is very rare that resealing occurs spontaneously with rewarding outcome. PPROM is defined as rupture of the fetal membranes prior to 37 weeks gestation and prior to the onset of labor [4] [5]. Previable PPROM is defined as spontaneous rupture of membrane occurring between 13 and 23. A small proportion of women with membrane rupture can expect cessation of fluid leakage (2.8 to 13 percent), that occuring subsequent to amniocenteis. The resealing of spontaneous PPROM is rare. The case presented here is an example of this rare condition
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